Journal of the National Cancer Institute · 2026
Menopause-related quality of life 5 years after salpingectomy with delayed oophorectomy vs salpingo-oophorectomy.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Gootzen Tamar A, Hermens Rosella P M G, van Gelder Marleen M H J, Heijnen Elle, van Bommel Majke H D, Apperloo Mirjam J A, Brood-van Zanten Monique M A, Coppus Sjors F P J, Custers Jose A E, van Doorn Helena C, Gaarenstroom Katja N, Harmsen Marline G, IntHout Joanna, Knippenberg Marjan, van Lonkhuijzen Luc R C W, Mourits Marian J E, Piek Jurgen M J, Schuurman Teska N, Simons Michiel, Slangen Brigitte F M, Tros Rachel, Vos M Caroline, Zweemer Ronald P, Kets C Marleen, de Hullu Joanne, Steenbeek Miranda P
Аннотация
BACKGROUND: BRCA1/2 pathogenic variant (PV) carriers have an increased risk of tubo-ovarian cancer. They are recommended to have a risk-reducing salpingo-oophorectomy around age 40, resulting in premature menopause. The alternative risk-reducing salpingectomy (RRS) with delayed oophorectomy (DO) postpones this. We present the 5-year results of a nationwide preference trial (TUBA study) comparing menopause-related quality of life (QoL) after RRS/DO with salpingo-oophorectomy.
METHODS: Premenopausal BRCA1/2-PV carriers aged 25-40 (BRCA1) or 25-45 (BRCA2) chose RRS/DO or salpingo-oophorectomy with or without hormonal replacement therapy (HRT). We compared QoL (Greene Climacteric Scale) between RRS/DO and salpingo-oophorectomy without HRT 5 years after surgery using linear mixed models. Secondarily, RRS/DO was compared with salpingo-oophorectomy with HRT. Women who underwent oophorectomy in the RRS/DO group were excluded in a sensitivity analysis.
RESULTS: In total, 410 (71.9%) participants chose RRS/DO and 160 (28.1%) salpingo-oophorectomy. Seventy-three (17.8%) participants underwent oophorectomy within 5 years after salpingectomy. The adjusted mean difference (aMD) in QoL was 1.8 (95% CI = -0.6 to 4.3) after salpingo-oophorectomy without HRT and 1.4 (95% CI = -0.4 to 3.1) after salpingo-oophorectomy with HRT compared with RRS (with and without oophorectomy) at 5 years follow-up. The sensitivity analysis showed that QoL decreased less after RRS before oophorectomy compared with salpingo-oophorectomy without (aMD = 2.4, 95% CI = 0.1 to 4.8) and with HRT (aMD = 1.9, 95% CI = 0.1 to 3.7).
CONCLUSION: Postponing oophorectomy is key in preventing deterioration of QoL. QoL was similar 5 years after salpingectomy (with and without oophorectomy) compared with salpingo-oophorectomy (regardless of HRT use). However, QoL was higher when comparing salpingectomy without oophorectomy to salpingo-oophorectomy (regardless of HRT use).
METHODS: Premenopausal BRCA1/2-PV carriers aged 25-40 (BRCA1) or 25-45 (BRCA2) chose RRS/DO or salpingo-oophorectomy with or without hormonal replacement therapy (HRT). We compared QoL (Greene Climacteric Scale) between RRS/DO and salpingo-oophorectomy without HRT 5 years after surgery using linear mixed models. Secondarily, RRS/DO was compared with salpingo-oophorectomy with HRT. Women who underwent oophorectomy in the RRS/DO group were excluded in a sensitivity analysis.
RESULTS: In total, 410 (71.9%) participants chose RRS/DO and 160 (28.1%) salpingo-oophorectomy. Seventy-three (17.8%) participants underwent oophorectomy within 5 years after salpingectomy. The adjusted mean difference (aMD) in QoL was 1.8 (95% CI = -0.6 to 4.3) after salpingo-oophorectomy without HRT and 1.4 (95% CI = -0.4 to 3.1) after salpingo-oophorectomy with HRT compared with RRS (with and without oophorectomy) at 5 years follow-up. The sensitivity analysis showed that QoL decreased less after RRS before oophorectomy compared with salpingo-oophorectomy without (aMD = 2.4, 95% CI = 0.1 to 4.8) and with HRT (aMD = 1.9, 95% CI = 0.1 to 3.7).
CONCLUSION: Postponing oophorectomy is key in preventing deterioration of QoL. QoL was similar 5 years after salpingectomy (with and without oophorectomy) compared with salpingo-oophorectomy (regardless of HRT use). However, QoL was higher when comparing salpingectomy without oophorectomy to salpingo-oophorectomy (regardless of HRT use).